If a patient is not satisfied with the outcome of the cataract surgery he/she used to have two options: to get used to it or to replace the artificial lens one more time. Replacing an artificial lens, though, is much more risky than an initial cataract operation. However, Refractive Index Shaping is changing the game. It allows to change the refractive index of the IOL (intraocular lens) that were implanted during the cataract surgery.
OPHTHALMOLOGY ON THE VERGE OF A REVOLUTION-2
Ophthalmology: minimal yet phenomenal changes – it’s a revolution.
-“I can see at a distance, but that’s all,” says the patient, a retiree. Or it’s the opposite. “I have multifocal lenses. I can see up close and at a distance, but the halos are doing a number on me. I know that 2% of people get them, but why am I in that 2%?” What’s to be done in this situation?
Previously, surgeons had only two options. They could suggest that the patient just “get used to” the lens, or replace it. Replacing an artificial lens, though, is much riskier than an initial cataract operation. Especially if it had been 6 months or more. There is also a risk that the new lens will be imperfect. The absolute accuracy of the lens is never guaranteed. Laser correction is another option, but you have to keep in mind that these patients are not young, and neither are their corneas. There are no easy solutions. Furthermore, they are all expensive, risky, or both, and there are no guarantees.
– So what’s the point here?
Well, for the first time in 25 years… About that much time has passed since I stared at LASIK in amazement, even though it was an enormous arrangement that took up three rooms. However, the very fact that you could perform an operation on the cornea and change its refractive power was shocking for everyone, not just me. It completely changed treatment. It was not an evolution, but a revolution. Since then, I have gone to ophthalmology conferences every year. I see evolutionary things every time. Everything becomes more elegant and beautiful, but nothing is breathtaking. That is until I saw the presentation I’m about to talk about. It turns out that by adapting the technology we already have, the femtosecond laser, it’s possible to perform Refractive Index Shaping.
OPHTHALMOLOGY AND REVOLUTION
– Can you explain what that is?
– Suppose you have a lens and there’s no rejection or opacification, and it’s of the correct shape, but the refraction is off. Maybe there’s a plus or a minus, astigmatism, or the patient has a mono-focal lens and wants a multifocal one. Or vice versa. What if we could use a laser to change the “old-new” lens that’s already in there? Turns out this can be done!
(to be continued)
Interviewed by Sebastian Varo